Name: a unified methodological framework for vestibular schwannoma research
Uploaded: 2017-06-20T13:00:00
Description: Watch this Scientific Journal Video about A Unified Methodological Framework for Vestibular Schwannoma Research at JoVE.com

This work was supported by the National Institute of Deafness and Other Communication Disorders grants R01DC015824 (K.M.S.) and T32DC00038 (supporting J.E.S and S.D.), the Department of Defense grant W81XWH-14-1-0091 (K.M.S.), the Bertarelli Foundation (K.M.S.), the Nancy Sayles Day Foundation (K.M.S.), the Lauer Tinnitus Research Center (K.M.S.), and the Barnes Foundation (K.M.S.).

Written informed consent for the collection of all samples was obtained prior to surgery, and the experiments were carried out according to the Code of Ethics of the World Medical Association (Declaration of Helsinki). All sections of the study protocol were approved by the Institutional Review Board of Massachusetts Eye and Ear and Massachusetts General Hospital.
NOTE: Sections 1-7 below are designed to be performed sequentially upon the receipt of a primary human VS or GAN sample from the op...

<ol>
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E., Caye-Thomasen, P., Tos, T., Thomsen, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=What+is+the+real+incidence+of+vestibular+schwannoma?.">What is the real incidence of vestibular schwannoma?.</a> Arch Otolaryngol Head Neck Surg. 130 (2), 216-220 (2004).</li><li>Stangerup, S. E., Caye-Thomasen, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Epidemiology+and+natural+history+of+vestibular+schwannomas.">Epidemiology and natural history of vestibular schwannomas.</a> Otolaryngol Clin North Am. 45 (2), 257-268 (2012).</li><li>Mahaley, M. S., Mettlin, C., Natarajan, N., Laws, E. R., Peace, B. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+patterns+of+care+of+brain+tumor+patients+in+the+United+States:+a+study+of+the+Brain+Tumor+Section+of+the+AANS+and+the+CNS+and+the+Commission+on+Cancer+of+the+ACS.">Analysis of patterns of care of brain tumor patients in the United States: a study of the Brain Tumor Section of the AANS and the CNS and the Commission on Cancer of the ACS.</a> Clin Neurosurg. 36, 347-352 (1990).</li><li>Carlson, M. L., Link, M. J., Wanna, G. B., Driscoll, C. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Management+of+sporadic+vestibular+schwannoma.">Management of sporadic vestibular schwannoma.</a> Otolaryngol Clin North Am. 48 (3), 407-422 (2015).</li><li>Dilwali, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sporadic+vestibular+schwannomas+associated+with+good+hearing+secrete+higher+levels+of+fibroblast+growth+factor+2+than+those+associated+with+poor+hearing+irrespective+of+tumor+size.">Sporadic vestibular schwannomas associated with good hearing secrete higher levels of fibroblast growth factor 2 than those associated with poor hearing irrespective of tumor size.</a> Otol Neurotol. 34 (4), 748-754 (2013).</li><li>Caye-Thomasen, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=VEGF+and+VEGF+receptor-1+concentration+in+vestibular+schwannoma+homogenates+correlates+to+tumor+growth+rate.">VEGF and VEGF receptor-1 concentration in vestibular schwannoma homogenates correlates to tumor growth rate.</a> Otol Neurotol. 26 (1), 98-101 (2005).</li><li>Koutsimpelas, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+VEGF/VEGF-R+axis+in+sporadic+vestibular+schwannomas+correlates+with+irradiation+and+disease+recurrence.">The VEGF/VEGF-R axis in sporadic vestibular schwannomas correlates with irradiation and disease recurrence.</a> ORL J Otorhinolaryngol Relat Spec. 74 (6), 330-338 (2012).</li><li>Dilwali, S., Roberts, D., Stankovic, K. 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M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Secreted+Factors+from+Human+Vestibular+Schwannomas+Can+Cause+Cochlear+Damage.">Secreted Factors from Human Vestibular Schwannomas Can Cause Cochlear Damage.</a> Sci Rep. 5, 18599 (2015).</li><li>Blakeley, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+drug+treatments+for+neurofibromatosis+type+2-associated+vestibular+schwannoma.">Development of drug treatments for neurofibromatosis type 2-associated vestibular schwannoma.</a> Curr Opin Otolaryngol Head Neck Surg. 20 (5), 372-379 (2012).</li><li>Schroeder, R. D., Angelo, L. S., Kurzrock, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=NF2/merlin+in+hereditary+neurofibromatosis+2+versus+cancer:+biologic+mechanisms+and+clinical+associations.">NF2/merlin in hereditary neurofibromatosis 2 versus cancer: biologic mechanisms and clinical associations.</a> Oncotarget. 5 (1), 67-77 (2014).</li><li>Schularick, N. M., Clark, J. J., Hansen, M. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Primary+culture+of+human+vestibular+schwannomas.">Primary culture of human vestibular schwannomas.</a> J Vis Exp. 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This manuscript describes a unified methodological framework for VS research, outlining the simultaneous processing of human VS and GAN specimens for downstream research applications. As VS research enters the age of precision medicine, preparing the same sample in forms capable of answering numerous research questions will enable the discovery of molecular, cellular, genetic, and proteomic insights specific to individual patients.
The purity of human Schwann cell and VS cultures were thorough...

Vestibular schwannomas (VSs) are the most common neoplasms of the cerebellopontine angle, diagnosed in 1 in every 100,000 individuals. Though non-metastatic, these tumors severely affect a patient&#39;s quality of life1,2,3,4,5,6. Affected individuals commonly live with hearing loss, tinnitus, and a feeling of aural fullness. Symptoms become increasingly debilitating as the tumor grows, causing balance problems, facial paralysis, and impairment of other cranial nerve functions. Life-threatening complications due to brainstem compression may also ensue7.
Management options for VS are essentially limited to watchful waiting for static tumors and stereotactic radiation therapy or surgical resection for growing tumors8. The surgical removal of these tumors in research-affiliated hospitals presents the opportunity to acquire and analyze fresh tumor tissue collected during patient surgeries. One specific surgical approach to VS, the translabyrinthine resection, can even offer access to valuable human sensory epithelium from the inner ear and perilymph.
Because VSs arise from a peripheral sensory nerve (i.e., the vestibular nerve), it is important to compare VS-associated observations with those derived from an appropriate control nerve, such as the human great auricular nerve (GAN). Healthy GANs are regularly sacrificed during parotidectomies or neck dissections and can be used as robust models for healthy Schwann cell physiology9.
Because there are no FDA-approved drugs for the treatment or prevention of sporadic VS, it is imperative that researchers elucidate the underlying molecular mechanisms of the disease to identify therapeutic targets. Proteins that have been shown to play a role in VS pathogenesis include merlin, vascular endothelial growth factor (VEGF), cyclooxygenase 2 (COX-2), nuclear factor kappa B (NF-&#954;B), tumor necrosis factor alpha (TNF-alpha), epidermal growth factor receptor (EGFR), and related signaling molecules10,11,12,13,14,15,16,17.
Recent advances have expanded and improved protocols for the collection, processing, culture, and downstream investigation of primary human vestibular schwannomas and healthy nerve tissues18,19. However, most existing protocols are designed to accommodate the preparation of such tissues for a single downstream research application (i.e., cell culture alone). This article presents a unified methodological framework for the simultaneous processing of a single primary human VS or GAN sample for multiple downstream applications: cell type-specific culture, protein extraction, RNA preservation, tumor secretion collection, and tissue fixation. This work also details the surgical collection and processing of human cerebrospinal fluid (CSF) and perilymph during translabyrinthine VS resection, as these closely related tissues may serve as important sources of biomarkers for VS. Finally, this protocol presents steps for the viral transduction of primary human VS cells in culture as a novel application of this tissue for use in gene therapy.

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			<td height="42" style="height:42px;width:419px;">BioCoat Poly-D-Lysine/Laminin 12mm #1 German Glass Coverslip</td>
			<td style="width:159px;">Corning</td>
			<td style="width:159px;">354087</td>
			<td style="width:683px;">Or prepare coverslips with Corning Laminin (CB-40232) and Cultrex Poly-L-Lysine (3438-100-01)</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">CELLSTAR 15 ml Centrifuge Tubes, Conical bottom, Graduation, Sterile</td>
			<td style="width:159px;">Greiner Bio-One</td>
			<td style="width:159px;">188161</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">CELLSTAR 50 ml Centrifuge Tubes, Conical bottom, Graduation, Sterile</td>
			<td style="width:159px;">Greiner Bio-One</td>
			<td style="width:159px;">227261</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">CELLSTAR Cell Culture Dish, 60 mm</td>
			<td style="width:159px;">Greiner Bio-One</td>
			<td style="width:159px;">628160</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Collagenase from Clostridium histolyticum, Sterile-filtered</td>
			<td style="width:159px;">Sigma-Aldrich</td>
			<td style="width:159px;">C1639</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Costar 24 Well Clear TC-Treated Multiple Well Plates, Sterile</td>
			<td style="width:159px;">Corning</td>
			<td style="width:159px;">3526</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;">DAPI (4&#39;,6-Diamidino-2-Phenylindole, Dihydrochloride)</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">D1306</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">DMEM, high glucose, pyruvate, no glutamine, 500 ml</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">10313-039</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">DMEM/F-12, 500 ml</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">11320-033</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Dumont #3 Forceps, Dumoxel</td>
			<td style="width:159px;">Fine Science Tools</td>
			<td style="width:159px;">11231-30</td>
			<td>Autoclave prior to use</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Dumont #5 Forceps, Standard tip, Inox</td>
			<td style="width:159px;">Fine Science Tools</td>
			<td style="width:159px;">11251-20</td>
			<td>Autoclave prior to use</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">Fetal Bovine Serum, qualified, USDA-approved regions, 500 ml</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">10437-028&#160;</td>
			<td>Aliquot in 50 ml tubes and store in -20&#176;C freezer</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">Hyaluronidase from Bovine Testes, Type I-S, Lyophilized Powder</td>
			<td style="width:159px;">Sigma-Aldrich</td>
			<td style="width:159px;">H3506</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">Millex-GP Syringe Filter Unit, 0.22 &#181;m, polyethersulfone, 33 mm, sterile</td>
			<td style="width:159px;">EMD Millipore</td>
			<td style="width:159px;">SLGP033RS</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Paraformaldehyde, Reagent Grade, Crystalline</td>
			<td style="width:159px;">Sigma-Aldrich</td>
			<td style="width:159px;">P6148</td>
			<td>Prior to use: Establish Standard Operating Procedures based on protocols available online</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">PBS, pH 7.4, 500 ml</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">10010-023&#160;</td>
			<td>Autoclave prior to use</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">Penicillin-Streptomycin (10,000 U/ml), 100 ml</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">15140-122</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">PhosSTOP Phosphatase Inhibitor Tablets</td>
			<td style="width:159px;">Roche</td>
			<td style="width:159px;">04906845001</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">Pierce Protease Inhibitor Tablets</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">88666</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Pipettes and pipette tips, 5/10/25 ml</td>
			<td style="width:159px;">Variable</td>
			<td style="width:159px;">Variable</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Plastic Homogenization Pestle for 1.5/2.0ml Microtubes</td>
			<td style="width:159px;">E&#38;K Scientific</td>
			<td style="width:159px;">EK-10539</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">PrecisionGlide Needles, 27 G x 1 1/2 in&#160;</td>
			<td style="width:159px;">BD</td>
			<td style="width:159px;">301629</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">RIPA Buffer</td>
			<td style="width:159px;">Boston BioProducts</td>
			<td style="width:159px;">BP-115</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">RNAlater (RNA stabilization solution)</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">AM7021</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Safe-Lock Microcentrifuge Tubes, Polypropylene, 0.5 ml</td>
			<td style="width:159px;">Eppendorf</td>
			<td style="width:159px;">022363719</td>
			<td>Autoclave prior to use</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Safe-Lock Microcentrifuge Tubes, Polypropylene, 1.5 ml</td>
			<td style="width:159px;">Eppendorf</td>
			<td style="width:159px;">022363204</td>
			<td>Autoclave prior to use</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Saline - 0.9% Sodium Chloride Injection, bacteriostatic, 20 ml</td>
			<td style="width:159px;">Hospira</td>
			<td style="width:159px;">0409-1966-05</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Scalpel Blades - #15</td>
			<td style="width:159px;">Fine Science Tools</td>
			<td style="width:159px;">10015-00</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Schuknecht Suction Tube 24 gauge</td>
			<td style="width:159px;">Bausch + Lomb</td>
			<td style="width:159px;">N1698 42</td>
			<td>Useful for the surgical approach (in addition to common otologic surgical instruments) and e.g. a blue surgical marker</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Specimen Container, OR sterile, 4OZ&#160;</td>
			<td style="width:159px;">Medline</td>
			<td style="width:159px;">DYND30331H</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Stemi 2000-C Stereo Microscope</td>
			<td style="width:159px;">Zeiss</td>
			<td style="width:159px;">000000-1106-133</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Syringe/Needle Combination, Luer-Lok Tip, 5 ml, 22 G x 1 in.</td>
			<td style="width:159px;">BD</td>
			<td style="width:159px;">309630</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Tuberculin Syringe Only, Slip tip, 1 ml</td>
			<td style="width:159px;">BD</td>
			<td style="width:159px;">309659</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Tuberculin Syringe Only, Slip tip, 3 ml</td>
			<td style="width:159px;">BD</td>
			<td style="width:159px;">309656</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Ultrasonic homogenizer, 4710 Series, CV18 probe</td>
			<td style="width:159px;">Cole-Parmer</td>
			<td style="width:159px;">CP25013</td>
			<td></td>
		</tr>
	</tbody>
</table>

a unified methodological framework for vestibular schwannoma research

Vestibular schwannomas are the most common neoplasms of the cerebellopontine angle, making up 6-8% percent of all intracranial growths. Though these tumors cause sensorineural hearing loss in up to 95% of affected individuals, the molecular mechanisms underlying this hearing loss remain elusive. This article outlines the steps established in our laboratory to facilitate the collection and processing of various primary human tissue samples for downstream research applications integral to the study of vestibular schwannomas. Specifically, this work describes a unified methodological framework for the collection, processing, and culture of Schwann and schwannoma cells from surgical samples. This is integrated with parallel processing steps now considered essential for current research: the collection of tumor and nerve secretions, the preservation of RNA and the extraction of protein from collected tissues, the fixation of tissue for the preparation of sections, and the exposure of primary human cells to adeno-associated viruses for application to gene therapy. Additionally, this work highlights the translabyrinthine surgical approach to collect this tumor as a unique opportunity to obtain human sensory epithelium from the inner ear and perilymph. Tips to improve experimental quality are provided and common pitfalls highlighted.

Primary human VS cells in culture, as established in section 5, can be treated as informative models for disease-associated processes in many downstream research applications (Figure 1). Healthy Schwann cells cultured in section 6 provide a direct and instructive point of comparison. As outlined below, extensive data from VSs and GANs processed according to this unified methodological framework are available in multiple articles previously published<sup class...

Watch this Scientific Journal Video about A Unified Methodological Framework for Vestibular Schwannoma Research at JoVE.com

A Unified Methodological Framework for Vestibular Schwannoma Research

The goal of this protocol is to outline the collection and processing of human surgical samples for multiple downstream applications in vestibular schwannoma and Schwann cell research.

Vestibular schwannomas are the most common neoplasms of the cerebellopontine angle, making up 6-8% percent of all intracranial growths. Though these ...

The overall goal of this procedure is to process a human vestibular schwannoma sample received from the operating room for primary cell culture and collection of tumor secretions. This method can help answer key questions in the field of vestibular schwannoma research, such as how best to receive, store and process a primary human tumor sample intended for use in multiple biomolecular essays. The main advantage of this technique is that it makes use of a minimally manipulative culture method to propagate primary human vestibular schwannoma cells.The implications of this technique extend toward therapy for vestibular schwannoma because promising therapeutic candidates can be tested directly on cultured cells. Begin by transferring the specimen container holding the freshly harvested vestibular schwannoma or great auricular nerve sample from the ice used for transportation from the operating room to a laminar flow hood in the laboratory. Use sterile forceps to carefully transfer the specimen to the first of three 1.5 milliliter tubes filled with 1.4 milliliters of one exterior PBS.Close each tube once it contains the specimen and shake gently to wash. Place the sample in a dry 60 millimeter petridish and use forceps to remove all dead tissue in areas with prominent blood vessels. Use forceps or a scalpel blade to divide the sample into separate pieces for RNA preservation, protein extraction, secretion collection, fixation and cell culture.Transfer the piece of the specimen designated for cell culture to a new 60 millimeter culture dish containing five to eight milliliters of cold supplemented DMEM F12 medium. Place the piece of vestibular schwannoma or great auricular nerve designated for the collection of secretions into an empty 1.5 milliliter tube. Begin by pipetting 500 microliters of DMEM not supplemented with FBS, into two 1.5 milliliter tubes.The first tube will be used to collect the tumor secretions and the second tube will serve as a matched control. Place one of the DMEM containing tubes onto a calibrated digital scale. Tare the scale, place the piece of specimen designated for the collection of secretions into the tub and weigh it.Note the result, which will represent the weight of the tissue alone. Under a laminar flow hood, adjust the volume of DMEM in the tube to 100 microliters per 10 milligrams of the specimen. Place the tube containing the tissue sample and its matched control into the incubator.Incubate for at least 72 hours, to collect biologically useful quantities of tumor or nerve secretions. After incubation for 72 hours, use a one milliliter pipette to remove the secretion containing medium from the specimen. To prevent repeated freeze-thaw cycles, aliquot the medium into new tubes according to planned downstream analysis.Store the original tissue piece, secretions and control DMEM in a minus 80 degree celsius freezer until downstream applications are initiated. Begin the culture procedure by using a pair of forceps in each hand to separate the vestibular schwannoma tissue into approximately one milliliter cubed pieces. Then aspirate the medium and tumor pieces with a 10 millimeter serological pipette and transfer all contents to a 15 milliliter conical tube.Centrifuge for three minutes at 1000G at 25 degrees celsius. During the centrifugation, prepare disintegration medium by combining 4.7 milliliters of supplemented DMEM F12 medium with 250 microliters of collagenase and 50 microliters of hyaluronidase in a 60 millimeter culture dish. After centrifugation, the tumor pieces will form a palate at the bottom of the conical tube.Carefully pipette off and discard the supernatant. Then add two milliliters of freshly made enzyme containing disintegration medium to the tumor palate. Pipette up and down several times to mobilize the tissue and then transfer it to the 60 millimeter culture dish.Place the culture dish into the incubator for 18 hours, the next day, warm DMEM F12 medium supplemented with 10%FBS and 1%penicillin streptomycin in 37 degree celsius water bath. Remove the dish containing the vestibular schwannoma culture from the incubator and transfer to the flow hood. Using a 22 gauge needle attached to a six milliliter syringe, aspirate the culture containing medium and transfer it to a new 15 millimeter conical tube.Centrifuge for five minutes at 1000G at 37 degree celsius. In the mean time, use sterile forceps to place the required number of polydelycine and laminin coated glass cover slips into a 24 well culture plate. 24 to 32 wells can be cultured from a one centimeter cube tumor, so for most smaller tumors, planning for eight to 16 wells of culture cells is appropriate.After centrifugation, discard the supernatant and re-suspend the residual cell palate in the pre-warmed medium, to allow one milliliter of cell suspension per planned well. Use a five milliliter serological pipette to aspirate two milliliters of cell suspension and deposit one milliliter into a well of the 24 well plate. Continue aspirating and depositing tumor cell containing medium, aspirating in increments of two milliliters from which one milliliter is deposited into each planned well, until the tumor cell suspension is equally divided between all prepared wells.Place the 24 well plate, into the 37 degree celsius incubator overnight. Check the plate the next day, if significant debris is noted on the bottom of the wells, carefully change the medium in each well to new supplemented DMEM F12 culture medium, taking care not to dislodge adherent cells. If there is no debris, return the plate to the incubator and change the medium for the first time on day five and every three days thereafter.This bright field image illustrates the typical organizational pattern of vestibular schwannoma cells in culture. These immunofluorescent images of a primary human vestibular schwannoma culture were taking after 48 hours of exposure to GFP expressing ink 80, shown in green. The red fluorescence is from phalloidin F actin immuno staining, which stains the cytoskeleton and the blue fluorescence is dapi, which stains the nucleus.The inset, is a higher power image of a region of the low power image. While attempting this procedure, it's important to remember to write down the times you put the secretion sample and the culture sample into the incubator, to ensure later steps are followed after the correct incubation periods. Following this procedure, other methods like viral transduction, fixation, immunofluorescence, drug treatment and RNA extraction can be performed to answer additional questions, like how different viruses are expressed in cells or how gene expression changes after drug treatment.After its development, this technique paved the way for researchers in the field of vestibular schwannoma research to explore the way primary human cells respond to different drugs in living patients who have undergone surgery.

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